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Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
Moreira, Michel Rodrigues; Guimarães, Munick Paula; Rodrigues, Aurélia Aparecida de Araújo; Gontijo Filho, Paulo Pinto.
  • Moreira, Michel Rodrigues; Universidade Federal de Uberlândia. Instituto de Ciências Biomédicas. Laboratório de Microbiologia. Uberlândia. BR
  • Guimarães, Munick Paula; Universidade Federal de Uberlândia. Instituto de Ciências Biomédicas. Laboratório de Microbiologia. Uberlândia. BR
  • Rodrigues, Aurélia Aparecida de Araújo; Universidade Federal de Uberlândia. Instituto de Ciências Biomédicas. Laboratório de Microbiologia. Uberlândia. BR
  • Gontijo Filho, Paulo Pinto; Universidade Federal de Uberlândia. Instituto de Ciências Biomédicas. Laboratório de Microbiologia. Uberlândia. BR
Rev. Soc. Bras. Med. Trop ; 46(1): 39-44, Jan.-Feb. 2013. graf, tab
Article in English | LILACS | ID: lil-666792
ABSTRACT

INTRODUCTION:

Antimicrobial resistance is an increasing threat in hospitalized patients, and inappropriate empirical antimicrobial therapy is known to adversely affect outcomes in ventilator-associated pneumonia (VAP). The aim of this study was to evaluate antimicrobial usage, incidence, etiology, and antimicrobial resistance trends for prominent nosocomial pathogens causing ventilator-associated pneumonia in a clinical-surgical intensive care unit (ICU).

METHODS:

Gram-negative bacilli and Staphylococcus aureus causing VAP, as well as their antimicrobial resistance patterns and data on consumption (defined daily dose [DDD] per 1,000 patient days) of glycopeptides, extended-spectrum cephalosporins, and carbapenems in the unit were evaluated in two different periods (A and B).

RESULTS:

Antimicrobial use was high, mainly of broad-spectrum cephalosporins, with a significant increase in the consumption of glycopeptides (p < 0.0001) and carbapenems (p < 0.007) in period B. For Acinetobacter baumannii and members of the Enterobacteriaceae family, 5.27- and 3.06-fold increases in VAPs, respectively, were noted, and a significant increase in resistance rates was found for imipenem-resistant A. baumannii (p = 0.003) and third-generation cephalosporins-resistant Enterobacteriaceae (p = 0.01) isolates in this same period.

CONCLUSIONS:

Our results suggest that there is a link between antibiotics usage at institutional levels and resistant bacteria. The use of carbapenems was related to the high rate of resistance in A. baumannii and therefore a high consumption of imipenem/meropenem could play a major role in selective pressure exerted by antibiotics in A. baumannii strains.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pneumonia, Ventilator-Associated / Gram-Negative Bacteria / Gram-Positive Bacteria / Intensive Care Units / Anti-Bacterial Agents Type of study: Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Rev. Soc. Bras. Med. Trop Journal subject: Tropical Medicine Year: 2013 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Uberlândia/BR

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Full text: Available Index: LILACS (Americas) Main subject: Pneumonia, Ventilator-Associated / Gram-Negative Bacteria / Gram-Positive Bacteria / Intensive Care Units / Anti-Bacterial Agents Type of study: Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Rev. Soc. Bras. Med. Trop Journal subject: Tropical Medicine Year: 2013 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Uberlândia/BR